2022 ICD-10-CM Code S02.620G
Fracture of subcondylar process of mandible, unspecified side, subsequent encounter for fracture with delayed healing
Valid for Submission
| ICD-10: | S02.620G |
| Short Description: | Fx subcondylar process of mandible, unspecified side, 7thG |
| Long Description: | Fracture of subcondylar process of mandible, unspecified side, subsequent encounter for fracture with delayed healing |
Code Classification
S02.620G is a billable diagnosis code used to specify a medical diagnosis of fracture of subcondylar process of mandible, unspecified side, subsequent encounter for fracture with delayed healing. The code S02.620G is valid during the fiscal year 2022 from October 01, 2021 through September 30, 2022 for the submission of HIPAA-covered transactions.
The ICD-10-CM code S02.620G might also be used to specify conditions or terms like closed fracture of mandible, condylar process, closed subcondylar fracture of mandible, fracture of subcondylar process of mandible, open fracture of mandible, condylar process, open fracture of mandible, subcondylar , open fracture of ramus of mandible, etc. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.
S02.620G is a subsequent encounter code, includes a 7th character and should be used after the patient has completed active treatment for a condition like fracture of subcondylar process of mandible unspecified side for fracture with delayed healing. According to ICD-10-CM Guidelines a "subsequent encounter" occurs when the patient is receiving routine care for the condition during the healing or recovery phase of treatment. Subsequent diagnosis codes are appropriate during the recovery phase, no matter how many times the patient has seen the provider for this condition. If the provider needs to adjust the patient's care plan due to a setback or other complication, the encounter becomes active again.
Unspecified diagnosis codes like S02.620G are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.
Coding Guidelines
The principles of multiple coding of injuries should be followed in coding fractures. Fractures of specified sites are coded individually by site nd the level of detail furnished by medical record content.
A fracture not indicated as open or closed should be coded to closed. A fracture not indicated whether displaced or not displaced should be coded to displaced.
Initial vs. Subsequent Encounter for Fractures
Traumatic fractures are coded using the appropriate 7th character for initial encounter (A, B, C) for each encounter where the patient is receiving active treatment for the fracture. The appropriate 7th character for initial encounter should also be assigned for a patient who delayed seeking treatment for the fracture or nonunion.
Fractures are coded using the appropriate 7th character for subsequent care for encounters after the patient has completed active treatment of the fracture and is receiving routine care for the fracture during the healing or recovery phase.
Care for complications of surgical treatment for fracture repairs during the healing or recovery phase should be coded with the appropriate complication codes.
Care of complications of fractures, such as malunion and nonunion, should be reported with the appropriate 7th character for subsequent care with nonunion (K, M, N,) or subsequent care with malunion (P, Q, R).
Malunion/nonunion: The appropriate 7th character for initial encounter should also be assigned for a patient who delayed seeking treatment for the fracture or nonunion.
The open fracture designations in the assignment of the 7th character for fractures of the forearm, femur and lower leg, including ankle are based on the Gustilo open fracture classification. When the Gustilo classification type is not specified for an open fracture, the 7th character for open fracture type I or II should be assigned (B, E, H, M, Q).
Approximate Synonyms
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Closed fracture of mandible, condylar process
- Closed subcondylar fracture of mandible
- Fracture of subcondylar process of mandible
- Open fracture of mandible, condylar process
- Open fracture of mandible, subcondylar
- Open fracture of ramus of mandible
Diagnostic Related Groups - MS-DRG Mapping
The ICD-10 code S02.620G is grouped in the following groups for version MS-DRG V39.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC). applicable from 10/01/2021 through 09/30/2022.
| MS-DRG | MS-DRG Title | MCD | Relative Weight |
|---|---|---|---|
| 559 | AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC | 08 | 1.8679 |
| 560 | AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC | 08 | 1.0764 |
| 561 | AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC | 08 | 0.7911 |
The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.
Present on Admission (POA)
S02.620G is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here.
CMS POA Indicator Options and Definitions
| POA Indicator Code | POA Reason for Code | CMS will pay the CC/MCC DRG? |
|---|---|---|
| Y | Diagnosis was present at time of inpatient admission. | YES |
| N | Diagnosis was not present at time of inpatient admission. | NO |
| U | Documentation insufficient to determine if the condition was present at the time of inpatient admission. | NO |
| W | Clinically undetermined - unable to clinically determine whether the condition was present at the time of inpatient admission. | YES |
| 1 | Unreported/Not used - Exempt from POA reporting. | NO |
Replacement Code
S02620G replaces the following previously assigned ICD-10 code(s):
- S02.62XG - Fx subcondylar process of mandible, subs for fx w delay heal
Convert S02.620G to ICD-9 Code
The General Equivalency Mapping (GEM) crosswalk indicates an approximate mapping between the ICD-10 code S02.620G its ICD-9 equivalent. The approximate mapping means there is not an exact match between the ICD-10 code and the ICD-9 code and the mapped code is not a precise representation of the original code.
- V54.19 - Aftrce traum fx bone NEC (Approximate Flag)
Information for Patients
Fractures
A fracture is a break, usually in a bone. If the broken bone punctures the skin, it is called an open or compound fracture. Fractures commonly happen because of car accidents, falls, or sports injuries. Other causes are low bone density and osteoporosis, which cause weakening of the bones. Overuse can cause stress fractures, which are very small cracks in the bone.
Symptoms of a fracture are
- Intense pain
- Deformity - the limb looks out of place
- Swelling, bruising, or tenderness around the injury
- Numbness and tingling
- Problems moving a limb
You need to get medical care right away for any fracture. An x-ray can tell if your bone is broken. You may need to wear a cast or splint. Sometimes you need surgery to put in plates, pins or screws to keep the bone in place.
[Learn More in MedlinePlus]
Jaw Injuries and Disorders
Your jaw is a set of bones that holds your teeth. It consists of two main parts. The upper part is the maxilla. It doesn't move. The moveable lower part is called the mandible. You move it when you talk or chew. The two halves of the mandible meet at your chin. The joint where the mandible meets your skull is the temporomandibular joint.
Jaw problems include
- Fractures (broken bones)
- Dislocations
- Temporomandibular joint dysfunction
- Osteonecrosis, which happens when your bones lose their blood supply
- Cancers
Treatment of jaw problems depends on the cause.
[Learn More in MedlinePlus]
Code History
- FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
- FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
- FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
- FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018